Home Phone * Mobile Phone Work Phone Email * In case of emergency, who should we contact (name, relationship and phone number)? Why are you interested in volunteering with us? (Besides love of animals) Are there any tasks you would prefer to do or not to do? Do you have prior experience working / volunteering with or around animals? If so please describe. Please list any special skills, training, interests, or hobbies you would like to put to use? What Days and Times are you available to volunteer? PCHS tries to find homes for all the animals in our care. However, for medical or behavioral reasons, euthanasia may sometimes be the only and necessary option. Please share your thoughts about euthanasia. Do you have any pets? If so, how many and what kind? Are they spayed / neutered?(Having a pet is not a prerequisite to volunteering.) Have you been convicted of a criminal charge in the last 10 years? (A criminal conviction may or may not bar you from volunteering, depending on the nature of the crime.) If yes, please explain. Please mark the boxes for all the volunteer areas that interest you. (Check all that apply) Adoption Follow Up Volunteer - Call recent adopters to ensure a smooth transition Bake / Craft Sales - Provide goodies for bake sales, make crafts to sell at events and/or sitting at the sale table. Cat Room Attendant - Assist with cleaning and disinfecting cat rooms, clean litter boxes, change furniture coverings, clean and wash floors, walls and counters. Kennel Cleaning - Assist with cleaning routine for dogs as directed by staff. Maintenance Person / Groundskeeper - Clearing snow in the winter, mowing grass in the summer, general upkeep as well as assisting with any unforeseen issues that may arise. Media / Public Relations Committee - Help promote important issues, events, write articles for the web site and newsletter Newsletter Volunteer - Stuff envelopes for newsletters. Newsletter Volunteer- Writers, preparation, production and coordination. Small Animal, bird and reptile assistant - assist with cleaning per staff instructions. Special Events / Fundraiser Volunteer - Assist with set up, breakdown and participating in the event / fundraiser. Do you have any special interests or skills not previously mentioned? Please give us three people that are not related to you as references. Name * Phone * Name * Phone * Name * Phone * PIKE COUNTY HUMANE SOCIETY
Volunteer Agreement and Consent
Read the following statements and initial that you understand and will abide by the following:
Read the following statements and initial that you understand and will abide by the following: I agree to conduct myself in a courteous and professional manner as a volunteer and as a representative of the Pike County Humane Society. I agree to abide by all Pike County Humane Society policies and procedures. I authorize the Pike County Humane Society to contact the emergency contact on this application and to seek emergency medical care in case of accident, injury or illness. I agree that my services are provided on a volunteer basis without pay or compensation of any kind. I understand that before I can volunteer I must attend an orientation. A PCHS representative will be in contact regarding the next orientation. I hereby give my permission to allow the PCHS to use any photographs taken of me for public relations purposes which include web-site, television and any other media. I understand that in handling animals and performing other volunteer’s tasks there does exist a risk of injury including physical harm caused by the animals. I understand there are inherent risks involved when working with animals. I agree that on behalf of myself, my heirs, personal representatives and executors, to release, discharge, indemnify and hold harmless the Pike County Humane Society, its agents, employees, volunteers, directors and board of directors from any and all claims, causes of action, or demands of any nature of cause, including costs and attorney fees incurred by the pike County Humane Society in connection with the same, based on damages or injuries which may be incurred or sustained by me in any way connected with my services for the Pike County Humane Society including but not limited to animal bites, accidents, injuries, etc. If I fail to abide by the terms of this agreement I will be asked to leave the program at the sole discretion of the Pike County Humane Society. If there is anything else you would like us to know, please note below.
If you have any questions or comments, please feel free to contact the Volunteer Coordinator and/or board member. We appreciate the time and effort that you contribute and will work hard to make your volunteer experience with us a positive and rewarding one. Feedback is always welcome and encouraged!